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EvaluatePharma®
Orphan Drug Report 2018
5th Edition – May 2018
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.2
The fifth edition of EvaluatePharma’s Orphan Drug Report brings together analyses to provide top-level insight, from the world’s financial markets, into the expected performance of the orphan drug market between now and 2024. Based on EvaluatePharma’s coverage of over 7,000 of the world’s leading pharmaceutical and biotech companies, the Orphan Drug Report 2018 highlights trends in prescription sales of orphan drugs, USA cost of treatment, leading products with an orphan drug designation, key companies in the rare diseases landscape and orphan drug designation analysis by region.
Additional copies are available at:www.evaluategroup.com/OrphanDrug2018
Welcome to the EvaluatePharma®
Orphan Drug Report 2018
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.3
An orphan drug is a pharmaceutical product that treats a rare condition or disease. The development of orphan drugs has been financially incentivised through US law via the Orphan Drug Act of 1983. The National Organization for Rare Disorders (NORD), which was instrumental in establishing the Act, currently estimates that there are as many as 7,000 rare diseases and that up to 30 million Americans suffer from a rare disease. Prior to the 1983 Act, 38 orphan drugs were approved in the United States. The success of the original Orphan Drug Act in the USA led to it being adopted in other key markets, most notably in Japan in 1993 and in the European Union in 2000.
Rare disease patient populations are defined in law as:• USA: <200,000 patients (<6.37 in 10,000, based on US population of 314m)
• EU: <5 in 10,000 (<250,000 patients, based on EU population of 514m)
• Japan: <50,000 patients (<4 in 10,000 based on Japan population of 128m)
Financial incentives by law include:Orphan drug exclusivity
During the period of marketing exclusivity, the regulatory bodies are barred from approving the same product for the same orphan indication. A product holding several separate orphan designations for different indications can have several separate market exclusivities, which can run concurrently.
• USA: Seven years of marketing exclusivity from approval.
• EU: Ten years of marketing exclusivity from approval.
• Japan: Ten years registration validity period (also known as re-examination period).
Reduced R&D costs
• USA: 50% Tax Credit on R&D Cost (owing to new tax legislation, is expected to decrease to 25%).
• USA: R&D Grants for Phase I to Phase III Clinical Trials.
• USA: User fees waived (FFDCA Section 526: Company WW Revenues <$50m).
• EU: EMA protocol assistance at a reduced cost.
• EU: Administrative and procedural assistance at a reduced fee for small and medium sized enterprises.
• EU: The EMA does not offer research grants but funding is available for the European Commission (EC) and other sources, such as Horizon 2020 and E-Rare.
• Japan: Orphan products can be subsidised through the National Institute of Biomedical Innovation (NIBIO).
• Japan: Guidance and consultations from the Pharmaceuticals and Medical Devices Agency (PMDA) at a lower user fee.
• Japan: 12% of study expenses incurred during the NIBIO payment period can be reported as a tax credit.
Overview
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.4
Orphan drug classification methodology
EvaluatePharma have identified all products that have orphan drug designations filed in the USA, EU or Japan.
These are available as part of the core EvaluatePharma service. To further enhance analysis, EvaluatePharma have defined an ‘Orphan’ sub-set of products using these criteria:
• Initial approval in the USA, EU or Japan was for a rare disease for which the product had orphan designation.
• Products not initially approved for treatment of an orphan indication, expected to generate more than 50% of sales from use in orphan indications. This has led to the exclusion of drugs such as Avastin, Enbrel, Herceptin, Humira and Remicade, all of which have orphan designations for indications contributing less than 50% of sales.
• Indication – the product is being examined in an indication that is classified as an orphan disease in and for which other products approved in this indication were also approved as orphan drugs.
• Company news – the company developing the product states it is seeking orphan drug designation for it’s lead indication.
All sales analysis in the report is based on this ‘Orphan’ sub-set of products. Product sales represent total brand sales.
Prices for products in the US are sourced from Medicare Part B, National Average Drug Acquisition Cost (NADAC), Federal Supply Schedule (FSS) and Medicaid.
Availability of a price point determines choice of source. The source is kept consistent across years to reflect a clear trend in pricing.
Overview
5
Foreword
The unmet medical needs of some of the sickest patients in society have pretty much guaranteed any developer working in the field of orphan drugs would be handsomely rewarded for their efforts.
However, EvaluatePharma’s fifth edition of the orphan drug report shows that although the overall market is growing strongly the year-on-year price increases orphan drugs can command have fallen.
This dip in the amount pharma companies are able to command for these rare disease products raises the question; has the pushback against orphan drug pricing begun?
The warning signs about orphan drug pricing started to appear last year, when both payers and politicians began to take a much closer look at these niche treatments. There was talk of abuses of the Orphan Drug Act and members of the US congress asked questions about the fairness of big pharma using the associated tax and regulatory advantages of developing orphan drugs.
The fact that this year’s report shows that seven of the top 10 companies by orphan sales are still big pharma groups, will not help the ongoing debate as to whether these well-funded groups should be benefiting from the regulatory and commercial advantages associated with orphan drugs.
Although pricing may have taken a bit of a pounding this year, in absolute terms the orphan drug market is growing strongly.
According to this year’s report sales of orphan drugs are set to climb by 11% a year all the way through to 2024, eventually reaching $262bn – this compares with 6.4% growth for the overall pharma market in the same period.
Despite the slowdown in pricing, the mean cost per patient per year still managed to hit $147,308 in 2017, more than four times the mean cost for non-orphan drugs at $30,708.
In terms of the sector’s biggest players, 2017 saw a significant reshuffle at the top, with Celgene toppling Novartis to take the crown as the company with the biggest orphan drug sales, thanks to Revlimid, which qualifies for orphan drug designation through its multiple myeloma indication.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.
6
Foreword
Report Author: Karen Pomeranz, PhD Managing Analyst, EvaluatePharma [email protected]
Foreword by: Lisa Urquhart Editor, EP Vantage [email protected]
Although the biggest company changed, Soliris retained its spot at the top as the sector’s most expensive drug, as the annual price of the treatment for paroxysmal nocturnal haemoglobinuria tipped over $500,000. But, this is likely to be Soliris’s last year as number one. In February, the FDA approved Biogen’s Spinraza for spinal muscular atrophy, with a price tag of $750,000 in the first year of treatment, falling to $350,000 in the second. There is also BioMarin’s Brineura for Batten disease, whose $27,000 biweekly injections add up to an annual list price of $702,000.
With payers already bristling at the cost of some of the newer orphan drugs on the market, the UK’s NICE has already rejected Brineura for being too expensive, those developing even more expensive products, like gene therapies, might find even tougher hurdles to reimbursement. Spark Therapeuticsrecently priced its retinal dystrophy gene therapy product, Luxturna at $850,000.
A recent survey by the Pharmacy Benefit Management Institute showed that cost is the primaryconcern for 55% of payers, and 71% do not believe that current prices are sustainable.
As such it will be difficult to predict the market impact of these types of innovation that will test existing payment models to their limits. Evaluate is taking a keen interest in this and orientating its industry content around these disruptive evolutions in the landscape.
However, pricing pressure might not be the only future brake on the growth of the rare disease sector. The recent US tax reform legislation, that gave big pharma their much vaunted tax holiday, alsoslashed the tax credit for orphan drug developers from 50% to 25%.
As such, the orphan drug market is at an interesting crossroads in its development. On the one hand with the cost of development set to rise and increasing payer pushback, the sector could become less attractive for both smaller and larger companies. Glaxosmithkline and Astrazeneca have already announced their intentions to withdraw from the space.
On the other hand there are still thousands of orphan conditions that remain untouched by medical innovation, making it an area still ripe with opportunity. But if the orphan drug sector is to achieve the growth targets ascribed to it, the trick will be to getting products to patients in the most efficient and cost effective way
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.7
Analysis Highlights
• Worldwide orphan drug sales are forecast to grow at a CAGR of 11.3% from 2018 to 2024, double the rate forecast for the non-orphan drug market.
• By 2024, orphan drugs are expected to capture a fifth of worldwide prescription sales and to reach $262bn.
• The mean price of the top 100 USA orphan drugs (ranked by sales) grew at an annual rate of 5.2% from 2013 to 2017 compared to 9.2% for the top 100 non-orphan drugs.
• Revlimid (lenalidomide) is forecasted to be the top selling orphan drug in the USA, in 2024.
• Soliris (eculizumab) was the highest revenue generating orphan drug, per patient in the USA, in 2017.
• Expected strong sales of Revlimid and Pomalyst (pomalidomide) will secure Celgene’s position as 2024 worldwide leader in orphan drug sales.
• Alexion Pharmaceuticals is the current worldwide leading company in the orphan drug market for blood indications.
• Oncology is the leading 2024 orphan drug therapy area accounting for about 50% of the total 2024 worldwide market. Blood is the second leading therapy area, accounting for about 12% of the market.
• Sales forecasts for pipeline orphan drugs account for over a third of total R&D pipeline sales through to 2024.
• Lanadelumab (Shire) is the most valuable R&D orphan drug with a NPV of $7.5bn.
• Implementation of the FDA’s orphan drug modernization plan has led to an increase in the number of orphan designation granted in the USA. Overall, the FDA has granted more orphan drug designations than any other regulatory body.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.8
Table of Contents
Contents
9 Worldwide Orphan Drug Sales (2002-2024)
10 Top 100 USA Drug Cost per Patient per Year (2013-2017)
12 2017: USA Revenue per Patient per Year for Top 20 Selling Orphan Drugs
14 Worldwide Orphan Drug Sales in 2024: Top 20 Companies
16 Worldwide Orphan Drug Sales in 2024 Excluding Oncology: Top 20 Companies
18 Share of Worldwide Orphan Drug Sales by Therapy Category (Excluding Oncology) and Lead Companies
20 Worldwide Oncology Orphan Drug Sales in 2024: Top 20 Companies
22 Worldwide Orphan Drug Sales: Top 20 Products
24 Worldwide Pipeline Sales to 2024: Orphan vs. Non-Orphan
25 Top 20 Orphan R&D Products based on NPV
27 USA, EU & Japan Orphan Designations per Year (2003-2017)
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.9
Worldwide Orphan Drug Sales (2002-2024)
Source: EvaluatePharma® May 2018Worldwide Orphan Drug Sales & Share of Prescription Drug Market (2002-2024)
WW
Pre
scri
ptio
n S
ales
($bn
)
Orp
han
Dru
g S
ales
as
a %
of P
resc
ript
ion
Sal
es
100
200
300
400
500
600
700
800
900
1000
20%
25%
15%
10%
5%
0%2005200420032002 2009200820072006 2013201220112010 2017201620152014 2021 20242020 2023202220192018
426397359315
548536502458
569571590558
583576565581
706828
662785748
631608
Prescription Excluding Generics & Orphan Generics Orphan Drugs as % of Prescription Sales
0
+11.3% CAGR 2018-24
32272416 54544741 70676659 80807775 99 11394 1091048984
Worldwide orphan drug sales forecast to total $262bn in 2024. The CAGR of orphan drugs between 2018 and 2024 forecast to be +11.3%, approximately double that of the non-orphan market. Orphan drugs set to be 21.7% of worldwide prescription sales by 2024.
EvaluatePharma® finds that sales of drugs designated as orphans will grow by 11% per year through to 2024, reaching $262bn. The growth of the orphan drug market is anticipated to be more
than double that of the overall prescription drug market, with orphan drugs set to account for a little over a fifth of all prescription drug sales by 2024. This is in comparison to 2017, when orphan drugs held just a 16% share of the market. The rapid growth in the orphan drug market share mainly stems from sales of currently approved therapies and not from expected sales, through to 2024, of R&D products (see page 24).
Worldwide Orphan & Prescription Drug Sales (2010-2024)
Worldwide sales ($bn)
Year 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024
Orphan drug sales 69 77 82 88 94 100 112 125 138 151 169 192 216 240 262
Growth per year +11.7% +6.7% +7.7% +6.8% +6.3% +12.5% +11.3% +9.9% +9.6% +11.9% +13.4% +12.9% +10.8% +9.2%
Orphan sales as a % of Rx 10.0% 10.5% 11.4% 12.1% 12.5% 13.5% 14.6% 15.9% 16.6% 17.3% 18.3% 19.2% 20.2% 21.1% 21.7%
Non-orphan drug sales 618 656 638 639 657 642 655 663 692 720 756 805 852 893 941
Growth per year +6.2% -2.7% +0.1% +2.8% -2.2% +2.0% +1.1% +4.4% +4.1% +5.1% +6.4% +5.9% +4.8% +5.3%
Prescription (Rx) (excluding generics)
627 667 653 657 675 665 688 708 746 782 831 897 965 1,024 1,090
Growth per year +6.3% -2.0% +0.6% +2.8% -1.5% +3.4% +2.9% +5.3% +4.9% +6.3% +8.0% +7.5% +6.2% +6.4%
Source: EvaluatePharma® May 2018
WW Orphan Drug Market CAGR 18-24 +11 .3%WW Non-Orphan Drug Market CAGR 18-24 +5.3%WW Prescription (Rx) Excluding Generics CAGR 18-24 +6.5%
Note: Industry sales based on Top 500 pharmaceutical and biotech companies.
Sales to 2016 based on company reported sales data. Sales for 2017 based on available company reported sales data. Sales forecasts to 2024 based on a consensus of leading equity analysts’ estimates for company product sales and segmental sales.
All sales analysis based on EvaluatePharma®’s ‘Orphan Drugs’ sub-set of products, as defined in the Overview section.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.10
Top 100 USA Drug Cost per Patient per Year (2013-2017)
part 1 of 2
100,00040,000
40,00020,000 120,000 140,00060,000 80,000 100,000 160,000
Source: EvaluatePharma® May 2018Mean Cost per Patient per Year (2013-2017)
Yea
r
Cost per Patient ($)Orphan Non-Orphan
201628,904
145,262
201525,504
134,062
201423,503
129,970
201321,589
120,382
20,000 60,000 80,000
Source: EvaluatePharma® May 2018Median Cost per Patient per Year (2013-2017)
Yea
r
Cost per Patient ($)Orphan Non-Orphan
201715,809
84,062
201615,571
97,280
20159,637
82,701
20148,768
20138,017
78,954
0
201730,708
147,308
0
88,314
Mean orphan drug cost to USA patients $147,308 in 2017; median orphan drug cost $84,062.
EvaluatePharma® estimates that the mean cost per patient per year of an orphan drug was $147,308 versus $30,708 for a non-orphan drug (analysis based on the top 100 drugs in the USA in 2017). Whilst the drug price has increased year-on-year for both orphan and non-orphan drugs since 2013, the growth rate for both was significantly lower in 2017 compared to previous years which may be due to increasing pressure on drug developers to reduce to cost of treatment.
In 2017, seven drugs from our analysis had a mean cost of over $300,000 per patient. Of these seven, over half were drugs within the blood therapy category, highlighting the vital importance and demand for the development of successful therapies for rare blood disorders. Analysis showed increasing median prices for both orphan and non-orphan drugs, with the non-orphan drug prices displaying steeper increases, thus closing the considerable gap between non-orphan and orphan drug prices.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.11
Top 100 Orphan and Non-Orphan USA Drugs by Sales Mean and Median Cost per Patient per Year (2013-2017)
Source: EvaluatePharma® May 2018
Top 100 USA Drug Cost per Patient per Year (2013-2017) part 2 of 2
Note: All sales analysis based on EvaluatePharma®’s ‘Orphan Drugs’ sub-set of products, as defined in the Overview section.
Cost per patient is an estimate for the retail cost of a drug to a patient, for a given year, based on a 100% compliance to the treatment guidelines outlined in the FDA label. Depending on the underlying pricing source data used, the price may or may not include off-invoice discounts. The Top 100 orphan and non orphan drugs were ranked by USA sales for 2017.
Prices for products in the US are sourced from Medicare Part B, NADAC, FSS and Medicaid. Availability of a price point determines choice of source. The source is kept consistent across years to reflect a clear trend in pricing.
Cost per patient ($) per year 2013 2014 2015 2016 2017 CAGR
Orphan Mean cost 120,382 129,970 134,062 145,262 147,308 5.2%
Growth per year 8.0% 3.1% 8.4% 1.4%
Median cost 78,954 88,314 82,701 97,280 84,062
Non-Orphan Mean cost 21,589 23,503 25,504 28,904 30,708 9.2%
Growth per year 8.9% 8.5% 13.3% 6.2%
Median cost 8,017 8,768 9,637 15,571 15,809
Median cost differential (orphan/non-orphan) 9.8 10.1 8.6 6.2 5.3
Median price increase 2013/17:
Orphan: 1.06
Non-Orphan: 1.97
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2017: USA Revenue per Patient per Year for Top 20 Selling Orphan Drugs
Source: EvaluatePharma® May 2018Top 20 USA Orphan Drugs in 2017 by Sales; Revenue per Patient Vs. No. of Patients Treated
US
A R
even
ue p
er P
atie
nt p
er Y
ear
($)
USA No. of Patients per Year
0
100,000
300,000
200,000
400,000
500,000
600,000
y = 1E+08x -0.742
R2 = 0.7563
Soliris (ALXN)
Orkambi (VRTX)
Sprycel (BMY)
Pomalyst (CELG)
Revlimid (CELG)
Rituxan (ROG)
150,000 200,000 250,000100,00050,0000
Soliris was the highest revenue generating orphan drug in 2017; revenue per patient and number of patients treated correlates with ultra-rare drugs achieving highest revenues per patient.
EvaluatePharma® discovered that, in general, as the number of patients treated increased, the revenue per patient decreased (based on the Top 20 selling orphan drugs in the USA). The strength of this correlation increased further for orphan drugs that treated fewer than
10,000 patients, confirming that there is the potential for big gains in those companies willing to invest in ultra-rare diseases. Soliris (eculizumab), originally developed to treat the rare blood disorder (paroxysmal nocturnal haemoglobinuria) continues to be the orphan drug that commands the highest revenue per patient in the USA, despite treating less than 2,500 patients in 2017.
USA Top 10 Selling Orphan Drugs in 2017 by Sales Source: EvaluatePharma® May 2018
part 1 of 2
Rank Product Generic name Company USA sales ($m) 2017
Revenues per patient 2017*
No. of patients 2017
1. Revlimid lenalidomide Celgene 5,426 184,011 29,487
2. Rituxan rituximab Roche 4,199 65,009 64,594
3. Copaxone glatiramer acetate Teva Pharmaceutical Industries 3,116 60,906 50,061
4. Opdivo nivolumab Bristol-Myers Squibb 3,102 43,847 70,746
5. Keytruda pembrolizumab Merck & Co 2,309 56,910 40,573
6. Imbruvica ibrutinib AbbVie 2,144 126,820 16,906
7. Avonex interferon beta-1a Biogen 1,594 78,262 20,367
8. Sensipar cinacalcet hydrochloride Amgen 1,374 6,287 218,559
9. Soliris eculizumab Alexion Pharmaceuticals 1,235 501,719 2,462
10. Xyrem sodium oxybate Jazz Pharmaceuticals 1,187 81,624 14,539
*Revenues per patient: An estimate of the dollar ($) revenues per year received, by a company, per patient for a drug in the USA market. This takes into account the cost per patient (average mg per year multiplied by the cost per mg), off-invoice discount and patient compliance.
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2017: USA Revenue per Patient per Year for Top 20 Selling Orphan Drugs
part 2 of 2
Note: Sales represent company reported sales where available, otherwise based on an average of equity analyst estimates.
USA sales represent sales for all indications.
EvaluatePharma® analysed the Top 10 selling USA drugs which treated fewer than 10,000 patients in 2017.
All sales analysis based on EvaluatePharma®’s ‘Orphan Drugs’ sub-set of products, as defined in the Overview section.
Prices for products in the US are sourced from Medicare Part B, NADAC, FSS and Medicaid. Availability of a price point determines choice of source. The source is kept consistent across years to reflect a clear trend in pricing.
Source: EvaluatePharma® May 2018Top 10 USA Orphan Drugs in 2017 by Sales (fewer than 10,000patients treated); Revenue per Patient Vs. No. of Patients Treated
US
A R
even
ue p
er P
atie
nt p
er Y
ear
($)
USA No. of Patients per Year
0
100,000
200,000
300,000
400,000
500,000
700,000
600,000 Soliris (ALXN)
Eloctate (BIVV)Orkambi (VRTX)
10,0009,0008,0007,0006,0005,0004,0003,0002,0001,0000
y = 3E+08x-0.893
R2 = 0.8016
Cinryze (SHP)
NovoSeven (NOVO B)
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Worldwide Orphan Drug Sales in 2024: Top 20 Companies
Celgene is expected to be the leading company in the orphan drug market in 2024 with sales of $18.4bn; all other companies ranked in the top five are expected to achieve sales ranging from $13.4bn to $15bn.
EvaluatePharma® finds that anticipated strong sales of Revlimid Pomalyst (pomalidomide), Imbruvica (ibrutinib) and Darzalex (daratumumab) – all used to treat haematological malignancies – will result to Celgene and Johnson & Johnson being lead companies, by sales, of the worldwide orphan drug market in 2024. In fact, more than 60% of orphan drug sales assigned to the top 10 companies in 2024 are expected to come from sales
in the oncology therapy area. Alexion Pharmaceuticals is the only company in the top 10 list that we do not anticipate to have any sales in oncology orphan indications in 2024. The main source of revenue for Alexion Pharmaceuticals is Soliris, which is used in the blood therapy area. Our analysis shows AstraZeneca will be ranked in 12th position in 2024, moving up 29 places from the company’s current position. This change is due to expected strong uptake of Calquence (acalabrutinib) and increased sales of Lynparza (olaparib). Seven of the top 10 companies are major pharmaceutical companies and we expect these companies to account for 35% of the total 2024 orphan drug market.
WW orphan sales ($bn) WW market share Rank
Rank Company 2017 2024 % CAGR 17-24 2017 2024 Chg. (+/-) Chg. (+/-)
1. Celgene 10.0 18.4 +9.0% 8.0% 7.0% -1.0% +2
2. Johnson & Johnson 5.0 15.0 +17.1% 4.0% 5.7% +1.8% +5
3. Novartis 12.4 14.2 +2.0% 9.9% 5.4% -4.5% -2
4. Roche 10.3 13.5 +3.9% 8.2% 5.2% -3.1% -2
5. Merck & Co 5.3 13.4 +14.2% 4.2% 5.1% +0.9% +1
6. Bristol-Myers Squibb 7.3 11.1 +6.2% 5.8% 4.2% -1.6% -1
7. Shire 7.8 8.8 +1.7% 6.2% 3.3% -2.8% -3
8. AbbVie 2.6 8.6 +18.5% 2.1% 3.3% +1.2% +8
9. Sanofi 3.9 7.4 +9.4% 3.1% 2.8% -0.3% +1
10. Alexion Pharmaceuticals 3.5 7.2 +10.6% 2.8% 2.7% -0.1% +1
11. Pfizer 4.9 5.0 +0.2% 3.9% 1.9% -2.0% -3
12. AstraZeneca 0.4 4.2 +42.4% 0.3% 1.6% +1.3% +29
13. Amgen 3.3 3.8 +2.2% 2.6% 1.5% -1.2% -
14. BioMarin Pharmaceutical 1.2 3.8 +18.1% 0.9% 1.4% +0.5% +13
Worldwide Orphan Drug Sales (2017-2024): Top 20 Companies & Total Market Source: EvaluatePharma® May 2018
WW
Orp
han
Pre
scri
ptio
n S
ales
($bn
)
4
8
12
16
20
4
6
10
14
18
Johnson &Johnson
Novartis
14.2
Roche Merck & Co
13.4
Bristol-MyersSquibb
Shire AbbVie Sanofi AlexionPharmaceuticals
7.2
Source: EvaluatePharma® May 2018Worldwide Orphan Prescription Drug Sales in 2024: Top 10 Companies
8.67.4
13.5
Celgene
18.4
0
8.8
15.0
11.1
part 1 of 2
Top 15-20 continued over…
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Worldwide Orphan Drug Sales in 2024: Top 20 Companies part 2 of 2
WW orphan sales ($bn) WW market share Rank
Rank Company 2017 2024 % CAGR 17-24 2017 2024 Chg. (+/-) Chg. (+/-)
15. Vertex Pharmaceuticals 2.2 3.5 +7.2% 1.7% 1.3% -0.4% +4
16. Biogen 3.0 3.4 +1.7% 2.4% 1.3% -1.1% -1
17. Sorrento Therapeutics - 3.3 n/a - 1.3% - -
18. Bayer 3.0 2.8 -1.3% 2.4% 1.1% -1.4% -4
19. Incyte 1.2 2.7 +12.3% 1.0% 1.0% +0.1% +6
20. Jazz Pharmaceuticals 1.6 2.6 +7.5% 1.3% 1.0% -0.3% +3
Total Top 20 88.9 152.7 +8.0% 71.0% 58.4% -12.7%
Other 36.3 108.9 +17.0% 29.0% 41.6%
Total 125 262 +11.1% 100.0% 100.0%
Note: All sales analysis based on EvaluatePharma®’s ‘Orphan’ sub-set of products, as defined in the Overview section. Total numbers reflect rounding.
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Worldwide Orphan Drug Sales in 2024 Excluding Oncology: Top 20 Companies
Shire and Alexion Pharmaceuticals lead EvaluatePharma’s non-oncology company ranking in 2024, with both companies booking the majority of their sales in the blood therapy category.
EvaluatePharma® conducted a secondary analysis of the companies active in the orphan drug space excluding orphan products in the oncology therapy area. Despite an anticipated decrease in worldwide market share of 4.6% from 2017 to 2024, Shire is expected to remain the top selling company in this space and in 2024 to secure sales of $8.2bn, of which about half are forecast to come from blood indications. Only three companies in the top 10 – Johnson & Johnson, Vertex Pharmaceuticals and Biogen – are not expected to generate
any revenue in 2024 from sales of orphan drugs in blood indications. Intercept Pharmaceuticals is expected be the 15th largest company in the non-oncology market space in 2024, moving up 37 positions from 2017, owing to a strong increase in sales of Ocaliva (obeticholic acid). The non-oncology space is expected to grow at a CAGR of 9.6% from 2017 to 2024, which is lower than the 12.7% CAGR expected in the oncology orphan drug market. Interestingly, sales of both non-oncology and oncology orphan drugs are each forecast to reach about $131bn in 2024. The top 20 companies in 2024 are forecast to represent about 56% of the non-oncology orphan market in 2024.
Worldwide Orphan Drug Sales Excluding Oncology: Top 20 Companies & Total Market Source: EvaluatePharma® May 2018
3
WW
Orp
han
Pre
scri
ptio
n S
ales
Exc
l. O
ncol
oty
($bn
)
1
2
4
5
6
7
8
9
Source: EvaluatePharma® May 2018
WW Orphan Drug Sales in 2024 by Therapy Category (Excluding Oncology):Top 10 Companies
Shire
8.2
BiomarinPharmaceuticals
3.8
CSL
2.6
Johnson &Johnson
3.8
Biogen
3.4
VertexPharmaceuticals
3.5
Roche
5.7
Sanofi
6.9
Novartis
7.0
AlexionPharmaceuticals
7.2
0
Endocrine
Musculoskeletal
Blood
Respiratory
Systemic Anti-infectives
Central Nervous System
Immunomodulators
Dermatology
Cardiovascular
Gastro-Intestinal
Other Therapeutic Products
part 1 of 2
Top 9-20 continued over…
WW orphan sales ($bn) WW market share Rank
Rank Company 2017 2024 % CAGR 17-24 2017 2024 Chg. (+/-) Chg. (+/-)
1. Shire 7.5 8.2 1% 10.9% 6.3% -4.6% -
2. Alexion Pharmaceuticals 3.5 7.2 11% 5.2% 5.5% 0.3% +2
3. Novartis 5.0 7.0 6% 7.3% 5.3% -2.0% -1
4. Sanofi 3.5 6.9 10% 5.2% 5.2% 0.1% +1
5. Roche 2.0 5.7 16% 3.0% 4.4% +1.4% +7
6. Johnson & Johnson 1.3 3.8 16% 2.0% 2.9% +1.0% +12
7. BioMarin Pharmaceutical 1.2 3.8 18% 1.7% 2.9% +1.2% +14
8. Vertex Pharmaceuticals 2.2 3.5 7% 3.2% 2.7% -0.5% +3
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.17
Worldwide Orphan Drug Sales in 2024 Excluding Oncology: Top 20 Companies
part 2 of 2
Note: All sales analysis based on EvaluatePharma®’s ‘Orphan’ sub-set of products, as defined in the Overview section. Analysis excluded products categorised in the oncology therapeutic category to produce a non-oncology company list. Total numbers reflect rounding.
WW orphan sales ($bn) WW market share Rank
Rank Company 2016 2022 % CAGR 16-22 2016 2022 Chg. (+/-) Chg. (+/-)
9. Biogen 3.0 3.4 2% 4.4% 2.6% -1.8% -3
10. CSL 1.9 2.6 5% 2.7% 2.0% -0.7% +4
11. Incyte 1.1 2.5 12% 1.7% 1.9% +0.3% +11
12. Pfizer 2.4 2.4 0% 3.5% 1.9% -1.6% -4
13. GW Pharmaceuticals - 2.3 n/a - 1.8% n/a -
14. Novo Nordisk 2.6 2.1 -3% 3.8% 1.6% -2.2% -7
15. Intercept Pharmaceuticals 0.1 1.9 47% 0.2% 1.5% +1.3% +37
16. argenx - 1.9 n/a - 1.5% n/a -
17. Athersys - 1.9 n/a - 1.4% n/a -
18. Jazz Pharmaceuticals 1.3 1.8 5% 2.0% 1.4% -0.6% -1
19. AveXis - 1.8 n/a - 1.4% n/a -
20. bluebird bio - 1.8 n/a - 1.4% n/a -
Total Top 20 39 73 9% 56.6% 55.6% -1.0%
Other 29.8 58.1 10% 43.4% 44.4%
Total 69 131 +9.6% 100.0% 100.0%
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.18
Share of Worldwide Orphan Drug Sales by Therapy Category (Excluding Oncology) and Lead Companies
Blood, and central nervous system are expected to be the leading therapy categories in the non-oncology space, together capturing about 43% of this market in 2024.
EvaluatePharma® finds that blood therapies command the largest share (around 28%) of the non-oncology worldwide orphan market, in both 2018 and 2024. Owing to high forecasted sales for Soliris, Alexion Pharmaceuticals is expected to remain the leading company in the blood therapy category. Driven by generic erosion of Copaxone (glatiramer acetate), the market share from products used in central nervous system indications will decrease from 19.7% in 2017 to 14.5% in 2024. This will also result in Teva Pharmaceuticals losing its position as lead company in this therapy category to GW
Pharmaceuticals in 2024. The decrease in market share of endocrine therapies from 11.8% in 2017 to 6.9% in 2024 can be attributed to generic erosion of Amgen’s Sensipar (cinacalcet). By 2024, Novartis will displace Amgen as leading company in this therapy category due to strong sales of Sandostatin LAR Depot (octreotide). The musculoskeletal therapy category will grow from 3.8% in 2017 to 9.4% in 2024 with Biogen remaining the sales leader in this category. The dermatology therapy category is expected to capture the lowest sales of all categories included in the non-oncology orphan drug market, with forecasted worldwide sales of $674m in 2024, equating to less than 1% of total market sales.
30%
Per
cent
age
of T
otal
Orp
han
Dru
g S
ales
(Exc
ludi
ng O
ncol
ogy)
10%
20%
40%
50%
60%
70%
80%
100%
90%
Source: EvaluatePharma® May 2018Share of Worldwide Orphan Drug Sales by Therapy Category (Excluding Oncology)
2017
27.6%
19.7%
11.8%
10.6%
9.4%
6.8%
3.8%
4.8%
4.0%
2024
28.7%
14.5%
6.9%
6.3%
7.2%
4.4%
9.4%
8.4%
11.5%
Blood
Respiratory
Musculoskeletal
Central Nervous System
Immunomodulators
Genito-Urinary
Cardiovascular
Gastro-Intestinal
Sensory Organs
Endocrine
Systemic Anti-infectives
Dermatology
0%
part 1 of 2
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.19
Share of Worldwide Orphan Drug Sales by Therapy Category (Excluding Oncology) and Lead Companies
part 2 of 2
Worldwide Sales and Lead Company by Therapy Category (Excluding Oncology) Source: EvaluatePharma® May 2018
WW annual sales ($bn) 2017 2024
Therapeutic category 2017 2024 Lead company WW sales ($m) Lead company WW sales ($m)
Blood 17.3 33.8 Shire 4,721 Alexion Pharmaceuticals 5,503
Central Nervous System 12.3 17.1 Teva Pharmaceutical Indus-tries
3,910 GW Pharmaceuticals 2,330
Endocrine 7.4 8.1 Amgen 1,730 Novartis 1,488
Cardiovascular 6.6 8.5 United Therapeutics 1,464 Johnson & Johnson 3,666
Respiratory 5.9 9.9 Vertex Pharmaceuticals 2,166 Vertex Pharmaceuticals 3,529
Immunomodulators 4.3 13.5 Novartis 1,296 Novartis 2,878
Systemic Anti-infectives 3.0 5.2 Merck & Co 787 Emergent BioSolutions 1,165
Gastro-Intestinal 2.5 7.5 Sanofi 1,707 Sanofi 2,398
Musculoskeletal 2.4 11.0 Biogen 884 Biogen 2,118
Genito-Urinary 0.7 1.3 AMAG Pharmaceuticals 387 Retrophin 457
Dermatology 0.19 0.7 Torii Pharmaceutical 125 Fibrocell Science 172
Sensory Organs 0.1 1.1 Valeant Pharmaceuticals International
37 Spark Therapeutics 930
Note: All sales analysis based on EvaluatePharma®’s ‘Orphan’ sub-set of products, as defined in the Overview section. Analysis excluded products categorised in the oncology therapeutic category to produce a non-oncology company list.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.20
Worldwide Oncology Orphan Drug Sales in 2024: Top 20 Companies
All top 10 companies in the 2024 oncology orphan drug market are major pharmaceutical companies; Celgene is ranked in first position with sales of $17.2bn.
EvaluatePharma® finds that driven by sales of Revlimid, Celgene is expected to be the lead company in the oncology orphan drugs market in 2024. This is in-line with the forecast that Celgene will be the overall leading company in the orphan drug market in 2024, underscoring the high sales orphan oncology products command. The high sales expected from the programmed cell death (PD)-1 inhibitors, Keytruda and Opdivo (nivolumab), have resulted in
Merck & Co and Bristol-Myers Squibb being respectively ranked in second and fourth position in 2024. Due to the expected increase in sales of Zejula (niraparib), TESARO will have the largest change in ranking and will move up 12 positions to 13th position in 2024. Bayer is expected to move down nine positions to 20th position, by 2024, owing to expected generic erosion of Nexavar (sorafenib). Overall, the top three companies in the oncology orphan drug market space – Celgene, Merck & Co and Johnson & Johnson – are expected toaccount for nearly a third of all sales in this segment in 2024.
WW orphan sales ($bn) WW market share Rank
Rank Company 2017 2024 % CAGR 17-24 2017 2024 Chg. (+/-) Chg. (+/-)
1. Celgene 10.0 17.2 8% 17.7% 13.2% -4.6% -
2. Merck & Co 4.1 12.8 18% 7.3% 9.8% +2.5% +3
3. Johnson & Johnson 3.6 11.2 17% 6.4% 8.6% +2.1% +3
4. Bristol-Myers Squibb 7.2 10.8 6% 12.7% 8.3% -4.4% -
5. Roche 8.3 7.8 -1% 14.6% 6.0% -8.6% -3
6. AbbVie 2.3 7.8 19% 4.0% 6.0% +2.0% +3
7. Novartis 7.4 7.2 -2% 13.0% 5.5% -7.5% -4
8. AstraZeneca 0.3 4.1 46% 0.5% 3.2% +2.6% +9
9. Pfizer 2.5 2.6 0% 4.5% 2.0% -2.5% -1
10. Amgen 0.9 2.4 15% 1.6% 1.9% +0.3% +2
11. Eisai 0.4 2.4 29% 0.7% 1.9% +1.1% +3
12. Eli Lilly 3.1 2.3 -5% 5.6% 1.7% -3.8% -5
13. TESARO 0.1 2.0 52% 0.2% 1.5% +1.4% +12
14. Seattle Genetics 0.3 1.7 27% 0.5% 1.3% +0.7% +2
15. Ono Pharmaceutical 0.8 1.6 10% 1.5% 1.2% -0.2% -2
Worldwide Oncology Orphan Drug Sales: Top 20 Companies & Total Market Source: EvaluatePharma® May 2018
WW
Orp
han
Pre
scri
ptio
n S
ales
Onc
olog
y ($
bn)
6
8
4
2
10
12
14
16
18
20
Merck & Co Bristol-MyersSquibb
Novartis AstraZeneca Pfizer
Source: EvaluatePharma® May 2018Worldwide Oncology Orphan Drug Sales in 2024: Top 10 Companies
4.1
2.6
10.8
Celgene
17.2
0
7.2
Amgen
2.4
AbbVie
7.8
Roche
7.8
Johnson &Johnson
11.2
12.8
part 1 of 2
Top 16-20 continued over…
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.21
Worldwide Oncology Orphan Drug Sales in 2024: Top 20 Companies part 2 of 2
WW orphan sales ($bn) WW market share Rank
Rank Company 2017 2024 % CAGR 17-24 2017 2024 Chg. (+/-) Chg. (+/-)
16. Kura Oncology - 1.5 n/a - 1.2% n/a -
17. Gilead Sciences 0.2 1.5 38% 0.3% 1.1% +0.9% +5
18. Epizyme - 1.4 n/a - 1.1% n/a -
19. Array BioPharma - 1.4 n/a - 1.0% n/a -
20. Bayer 1.0 1.3 4% 1.8% 1.0% -0.8% -9
Total Top 20 52.6 101.2 10% 93.0% 77.3% -15.6%
Other 4.0 29.7 33% 7.0% 22.7%
Total 57 131 +12.7% 100.0% 100.0%
Note: All sales analysis based on EvaluatePharma®’s ‘Orphan’ sub-set of products, as defined in the Overview section. Analysis excluded products categorised in the oncology therapeutic category to produce a non-oncology company list. Total numbers reflect rounding.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.22
WW product sales ($bn)
Rank Product Generic name Company Phase (current) Mechanism of action 2017 2024 CAGR
1. Keytruda pembrolizumab Merck & Co/Otsuka Holdings
Marketed Programmed cell death protein 1 (PD1) antibody
3.8 12.7 +19%
2. Revlimid lenalidomide Celgene/BeiGene Marketed Immunomodulator 8.2 11.9 +6%
3. Opdivo nivolumab Bristol-Myers Squibb/Ono Pharmaceutical
Marketed Programmed cell death protein 1 (PD1) antibody
5.7 11.2 +10%
4. Imbruvica ibrutinib AbbVie/Johnson & Johnson
Marketed Bruton’s tyrosine kinase (BTK) inhibitor 3.2 9.6 +17%
5. Darzalex daratumumab Johnson & Johnson
Marketed Lymphocyte differentiation antigen CD38 antibody
1.2 6.0 +25%
6. Soliris eculizumab Alexion Pharmaceuticals
Marketed Complement factor C5 antibody 3.1 5.2 +7%
7. Hemlibra emicizumab Roche/Chugai Pharmaceutical
Marketed Coagulation factor IXa antibody; Coagulation factor X antibody
0.0 4.4 +183%
8. Jakafi ruxolitinib phosphate
Incyte/Novartis Marketed Janus kinase 1 (JAK1) inhibitor; Janus kinase 2 (JAK2) inhibitor
1.9 3.9 +11%
9. Venclexta venetoclax AbbVie/Roche Marketed B-cell lymphoma 2 (BCL-2) inhibitor 0.1 2.8 +54%
10. Epidiolex cannabidiol GW Pharmaceuticals
Filed Cannabinoid (CB) receptor agonist - 2.3 n/a
Top 11-20 continued over…
Worldwide Orphan Drug Sales: Top 20 Products
Keytruda is expected to be the leading orphan drug in 2024.
EvaluatePharma® finds that Keytruda (pembrolizumab) is the world’s largest orphan drug in 2024, with total sales of $12.7bn and just over half these sales generated in the USA. Revlimid slides to second place with forecast sales of $11.9bn, 85% of which will stem from the USA. Other key movers include Hemlibra (emicizumab; +183% CAGR), Venclexta (venetoclax; +54% CAGR) and Zejula (+52% CAGR). Hemlibra launched in 2017 as a prophylactic for Haemophilia A, while Venclexta
first launched in 2016, for the treatment of chronic lymphocytic leukaemia (CLL). Zejula launched in 2017, for the treatment of ovarian and fallopian tube cancer. Rituxan’s (rituximab) sales are forecasted to decrease from $7.5bn in 2017 to $2.1bn (-17% CAGR) in 2024, owing to key patent expiry and consequent biosimilar adoption. Overall, the top 10 account for approximately 25% of the orphan drug market in 2024, with programmed cell death (PD)-1 inhibitors (Keytruda and Opdivio accounting for almost 10%.
part 1 of 2W
W P
rodu
ct S
ales
($bn
)
Source: EvaluatePharma® May 2018Top 10 Selling Orphan Drugs in 2024 by Worldwide Sales (All Indications)
6
4
2
8
10
12
14
Keytruda
5.9
6.8
Epidiolex
0.6
1.8
Venclexta
0.8
2.0
Jakafi
1.4
2.5
Hemlibra
2.4
2.0
Soliris
2.8
2.5
Darzalex
2.2
3.8
Imbruvica
4.1
5.5
Opdivo
6.0
5.3
Revlimid
1.8
10.2
0
ROW 2024US 2024
Worldwide Top 20 Selling Orphan Drugs in 2024 Source: EvaluatePharma® May 2018
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.23
Worldwide Orphan Drug Sales: Top 20 Products part 2 of 2
WW product sales ($bn)
Rank Product Generic name Company Phase (current) Mechanism of action 2017 2024 CAGR
11. Adcetris brentuximab vedotin
Seattle Genetics/Takeda
Marketed Tumour necrosis factor receptor superfamily member 8 (TNFRSF8) antibody
0.6 2.2 +20%
12. Lenvima lenvatinib mesylate Eisai Marketed Vascular endothelial growth factor receptor (VEGFR) inhibitor
0.3 2.2 +34%
13. Pomalyst pomalidomide Celgene Marketed Tumour necrosis factor alpha (TNFa) inhibitor 1.6 2.2 +4%
14. Lynparza olaparib AstraZeneca Marketed Poly (ADP-ribose) polymerase 1 (PARP1) inhibitor; Poly (ADP-ribose) polymerase 3 (PARP3) inhibitor; Poly (ADP-ribose) polymerase (PARP) inhibitor
0.3 2.2 +33%
15. Rituxan rituximab Roche Marketed B-lymphocyte antigen CD20 antibody 7.5 2.1 -17%
16. Spinraza nusinersen Biogen Marketed Survival motor neuron 2 (SMN2) protein inhibitor
0.9 2.1 +13%
17. Gazyva obinutuzumab Roche/Nippon Shinyaku
Marketed B-lymphocyte antigen CD20 antibody 0.3 2.1 +33%
18. Zejula niraparib TESARO Marketed Poly (ADP-ribose) polymerase 1 (PARP1) inhibitor; Poly (ADP-ribose) polymerase 2 (PARP2) inhibitor; Poly (ADP-ribose) polymerase (PARP) inhibitor
0.1 2.0 +52%
19. Uptravi selexipag Johnson & Johnson/Nippon Shinyaku
Marketed Prostacyclin receptor agonist 0.5 2.0 +21%
20. Ocaliva obeticholic acid Intercept Pharmaceuticals/Sumitomo Dainippon Pharma
Marketed Bile acid receptor agonist 0.1 2.0 n/a
Other 85.5 170.3 +12%
Total 125 262 +13.1%
Note: Sales represent company reported sales where available, otherwise based on an average of equity analyst estimates.
Worldwide sales represent sales for all indications.
All sales analysis based on EvaluatePharma®’s ‘Orphan’ sub-set of products, as defined in the Overview section. Total numbers reflect rounding.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.24
Worldwide Pipeline Sales to 2024: Orphan vs. Non-Orphan
Sales forecasts for pipeline orphan drugs account for over a third of total R&D pipeline sales through to 2024.
EvaluatePharma® finds that orphan products currently in R&D will account for 35-38% of sales generated from pipeline products from 2018 to 2024. The CAGR from 2018 to 2024 in the R&D orphan and non-orphan segments is comparable (133% for orphan products vs. 131% for non-orphan products. Hence, the value creation from orphan R&D products is not increasing more rapidly than from non-orphan R&D products. Both segments are likely to experience comparable
healthy growth through to 2024. Oncology and blood indications dominate the orphan drug pipeline (see page 25) with the leading R&D blood product being Shire’s lanadelumab with expected sales of nearly $1.6bn in 2024 and Array Biopharma’s encorafenib in oncology, with forecasted sales of $825m in 2024. The top five R&D candidates account for 22% of the total NPV (Phase III to filed). By 2024, orphan drugs currently in R&D are expected to garner sales of over $82bn while non-orphan drugs in R&D are expected to generate sales of about $147bn.
WW
Pro
duct
Sal
es ($
bn)
Source: EvaluatePharma® May 2018Worldwide Pipeline Sales to 2024: Orphan vs. Non-Orphan
100
50
150
200
250
2018
1.0
2020
20.512.4
2021
44.1
26.7
2022
74.0
44.4
2023
109.5
63.3
2024
146.8
82.4
0
OrphanNon-Orphan
2019
7.43.90.5
Worldwide Pipeline: Orphan vs. Non-Orphan Drugs to 2024 Source: EvaluatePharma® May 2018
WW sales ($bn)
R&D pipeline 2018 2019 2020 2021 2022 2023 2024 CAGR
Orphan 0.5 3.9 12.4 26.7 44.4 63.3 82.4 +133%
Non-orphan 1.0 7.4 20.5 44.1 74.0 109.5 146.8 +131%
% Orphan sales 35% 35% 38% 38% 37% 37% 36%
Total 1.5 11.4 33.0 70.8 118.3 172.8 229.2 +132%
Cumulative orphan 0.5 4.5 16.9 43.6 88.0 151.3 233.7
Cumulative non-orphan 1.0 8.4 29.0 73.1 147.0 256.6 403.4
Total 637
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.25
Top 20 Orphan R&D Products based on NPV
Of the top 20 orphan drugs currently in R&D, 40% could be blockbusters.
EvaluatePharma® finds that there are a number of potential blockbusters within the orphan drug pipeline. The top five orphan R&D drugs alone amass 20% of forecasted orphan drug pipeline sales in 2024. Lanadelumab (Shire) tops the list with an NPV of
$7.5bn and is currently filed in the USA for the treatment of hereditary angioedema. Oncology and blood are the leading therapy areas, with the majority of the top 20 pipeline candidates being developed for indications in these areas. In addition, while 11 of the top 20 R&D candidates are being developed in-house, the remainder have been acquired or are in-licensed.
part 1 of 2
1,000
Pro
duct
NP
V ($
m)
3,000
2,000
4,000
5,000
6,000
8,000
7,000
Lanadelumab
7,480
Lustpatercept
5,053
LentiGlobin
Source: EvaluatePharma® May 2018Top 10 Orphan Drugs in 2024 (Phase III/Filed) by NPV
Valoctocogene
4,576
Patisiran
4,477
Encorafenib
3,450
MultiStem
3,400
NuThrax
2,881
Gilteritinib
2,788
AVXS-101
5,458
0
4,749
Worldwide Top 20 Orphan R&D Drugs Based on NPV (Sales, NPV) Source: EvaluatePharma® May 2018
Rank Product Company Phase (current) Mechanism of action Sales ($m) 2024
WW NPV ($m)
Strategy
1. Lanadelumab Shire Filed Kallikrein (KLK) antibody 1,569 7,480 Company acquisition
2. AVXS-101 AveXis Phase III Survival of motor neuron (SMN) protein regulator 1,788 5,458 Organic
3. Luspatercept Celgene Phase III Activin receptor 2b antagonist 1,168 5,053 In-licensed
4. LentiGlobin bluebird bio Phase III Haemoglobin beta (HBB) gene therapy 1,615 4,749 Organic
5. Valoctocogene Roxaparvovec
BioMarin Pharmaceutical
Phase III Factor VIII gene regulator 1,318 4,576 In-licensed
6. Patisiran Alnylam Pharmaceuticals
Filed Transthyretin (TTR) RNAi therapeutic 1,308 4,477 Organic
7. Encorafenib Array BioPharma Filed Serine/threonine-protein kinase B-Raf inhibitor 825 3,450 Product acquisition
8. MultiStem Athersys Phase III Tumour necrosis factor (TNF) cell therapy 1,852 3,400 Organic
9. NuThrax Emergent BioSolutions
Phase III Bacillus anthracis immunoglobulin stimulant 1,102 2,881 Organic
10. Gilteritinib Astellas Pharma Phase III AXL inhibitor; FMS-like tyrosine kinase 3 (FLT3) inhibitor
905 2,788 In-licensed
Top 11-20 continued over…
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.26
Rank Product Company Phase (current) Mechanism of action Sales ($m) 2024
WW NPV ($m)
Strategy
11. Polatuzumab Vedotin
Roche Phase III IgM membrane glycoprotein antibody 520 2,632 Organic
12. AndexXa Portola Pharmaceuticals
Filed Coagulation factor Xa regulator 720 2,316 Organic
13. Selinexor Karyopharm Therapeutics
Phase III Exportin (XPO)/chromosome region maintenance protein (CRM) 1 inhibitor
970 2,315 Company acquisition
14. Larotrectinib Loxo Oncology Filed Tropomyosin receptor kinase (Trk) inhibitor 694 2,299 In-licensed
15. ABL001 Novartis Phase III Bcr/Abl fusion protein inhibitor 495 2,286 Organic
16. Rapastinel Allergan Phase III N-methyl-D-aspartate (NMDA) receptor regulator 676 2,282 Company acquisition
17. Ivosidenib Agios Pharmaceuticals
Filed Isocitrate dehydrogenase 1 (IDH1) inhibitor 757 2,119 Organic
18. Fedratinib Celgene Phase III Janus kinase 2 (JAK2) inhibitor 460 2,013 Company acquisition
19. Vosoritide BioMarin Pharmaceutical
Phase III Atrial natriuretic peptide receptor A (ANPRA) agonist; Fibroblast growth factor receptor 3 (FGFR3) inhibitor
627 1,936 Organic
20. Binimetinib Array BioPharma Filed Mitogen-activated protein kinase (MAPK) inhibitor 542 1,931 Organic
Other 22,045 59,078
Total 41,955 125,521
vs. Non-Orphan: 70,772 225,439
Top 20 Orphan R&D Products based on NPV part 2 of 2
Note: Sales represent company reported sales where available, otherwise based on an average of equity analyst estimates.
Factor VIII products for haemophilia A & B classified as orphan drugs.
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.27
USA, EU & Japan Orphan Designations per Year (2003-2017)
The USA continues to lead the EU and Japan in granting orphan drug designations.
The number of orphan drug designations granted by the FDA in 2017 increased from 320 in 2016 to 459 in 2017. This 43% increase is likely due to a rise in number of requests for orphan drug designations and to the implementation of the orphan drug modernisation plan by the FDA, which aims to eliminate the
agency’s backlog of existing designation requests and to ensure timely review of new applications. Conversely, the number of orphan drug designation granted in 2017 in the EU and Japan was lower than in recent years. Furthermore, the cumulative number of orphan drug designations granted by the FDA is more than double the number granted by the EMA and nearly 10 times higher that granted by the MHLW.
part 1 of 2
100
Des
igna
tions
Per
Yea
r
50
150
200
250
300
350
400
450
500
Source: EvaluatePharma® May 2018USA, EU & Japan Orphan Designations per Year (2003-2017)
201720162015201420132012201120102009200820072006200520042003
USA designations per year EU designations per year Japan designations per year
0
USA, EU & Japan Orphan Designations per Year (2003-2017)
Orphan designations
Year 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
USA designations per year 94 132 123 141 119 165 165 192 201 189 260 289 348 320 459
Growth per year +40% -7% +15% -16% +39% +0% +16% +5% -6% +38% +11% +20% -8% +43%
EU designations per year 54 74 91 82 100 74 109 130 107 148 124 201 191 210 150
Growth per year +23% -10% +22% -26% +47% +19% -18% +38% -16% +62% -5% +10% -29%
Japan designations per year 7 8 5 14 10 16 7 10 24 36 30 32 14 23 11
Growth per year +14% -38% +180% -29% +60% -56% +43% +140% +50% -17% +7% -56% +64% -52%
Source: EvaluatePharma® May 2018
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.28
USA, EU & Japan Orphan Designations per Year (2003-2017) part 2 of 2
0
1,500
1,000
500
2,000
3,000
2,500
3,500
5,000
4,000
4,500
Tota
l Des
igna
tions
Source: EvaluatePharma® May 2018USA, EU & Japan Orphan Drug Designations Cumulative Total
USA designations total EU designations total Japan designations total
200
6
200
7
200
8
200
9
2010
2011
2012
2013
2014
2015
2016
2017
200
4
200
5
200
3
Cumulative US, EU & Japan Orphan Designations & US Approvals per Year (2003-2017)
Orphan designations cumulative total
Year 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
USA designations total 1,283 1,415 1,538 1,679 1,798 1,963 2,128 2,320 2,521 2,709 2,967 3,254 3,601 3,914 4,373
Growth per year +10% +9% +9% +7% +9% +8% +9% +9% +7% +10% +10% +11% +9% +12%
EU designations total 182 256 347 429 529 603 712 842 949 1,097 1,221 1,422 1,613 1,823 1,973
Growth per year +36% +24% +23% +14% +18% +18% +13% +16% +11% +16% +13% +13% +8%
Japan designations total 167 175 180 194 204 220 227 237 261 297 327 359 373 396 407
Growth per year +5% +3% +8% +5% +8% +3% +4% +10% +14% +10% +10% +4% +6% +3%
Source: EvaluatePharma® May 2018
EvaluatePharma® Orphan Drug Report 2018 Copyright © 2018 Evaluate Ltd. All rights reserved.29
Since 1996 EvaluatePharma has been providing senior decision makers within the pharmaceutical industry with an essential service that models the sector from the viewpoint of the world’s financial markets.
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EvaluatePharma has captured the consensus forecasts of equity analysts and seamlessly integrated them with the historic results, as reported by companies. From this comprehensive view of the industry, its past and expected future performance emerges and can be analysed using EvaluatePharma. Analyses range from total market trends and therapeutic overviews to individual company performance and product progress.
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ORPHAN DRUG REPORT – MAY 2018
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